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Path to your heart (health)

The average death rate in the United States for cardiovascular disease is around one death every 38 seconds, according to the most recent report from the American Heart Association. More than one in six deaths in the U.S. in 2006 were from coronary heart disease.

Dr. Alan Gass, medical director of heart transplantation and mechanical circulatory support at Westchester Medical Center in New York, says obesity is a prime factor in this. “In the U.S., 66 percent of the population is overweight and over a third is obese,” he says. “Now they are predicting that by 2012 50 percent of the U.S. population is going to be obese. Obesity is directly related to high blood pressure, diabetes, heart attacks, arthritis and cancer. Therefore obesity is directly related to the majority of health problems in this country and probably represents the single biggest reversible expenditure for the U.S. government.”

Dr. Hunter Myers, a cardiologist in Rome, Ga., says the first risk factor he suggests changing is smoking. “That may be the hardest thing to do but the most quick return as far as risk factors,” he says. “[Smoking] speeds up your risk of heart disease.” He says nicotine patches and a prescription medicine called Chantix often work best, but a visit to the doctor can determine the best method for individuals. Next in line on Myers’ list of changes to lower risk of heart problems would be “things that affect your cholesterol” — meaning diet, he says.

Both Gass and Myers suggest that while eating healthy and exercising may be a struggle for some truck drivers, these things aren’t impossible to do on the road. Gass suggests finding ways to work in exercise, whether it be at a truckstop or at a gym chain with nationwide locations — make it “something that you have to fit in your life,” he says.

Talking to those who argue they don’t have time for exercise, Gass advises they imagine the problem as a little angel and little devil on either shoulder. “Most of the time the little devil on their shoulder is telling them they don’t have time to exercise. So I just tell them to take a minute and have a conversation with that little devil. Tell him, ‘I know you’re just screwing with my head.’ You can find a million excuses not to exercise, but most of those excuses are not founded in reality.” Gass says he also has his patients keep a food and exercise diary, which he suggests might be helpful for truckers.

“Another thing I preach is to live in the moment,” Gass says. “You can’t be hard on yourself for how you got to where you are because you’re unhealthy, nor can you say, ‘I weigh 350, and I have to weigh 200 — there’s no way I can do that.’ … Try not to look backwards, but to look forward. Guilt and blame, those are bad concepts. People should not feel bad about themselves, they should feel good about themselves.”

Gass says limiting or decreasing alcohol intake and smoking are other lifestyle changes that can help lower the risk of heart disease.

Myers says motivation is key to being healthy and preventing heart disease. “Most people get motivated by having something bad happen to them and getting a second chance,” he says. “Or they have another event that makes them want to live forever because something so good happened to them, like having a grandchild.”

A new lease

Randy Freels (before)

Averitt driver Randy Freels knew he was getting heavier as the years went by, and at 40 he decided to do something about it.

“I was at my heaviest, and I was just miserable and figured I’d better do something,” the Lenoir City, Tenn., resident says. “Heart disease runs in my family. So I figured it was time to turn it around and try to take care of myself.”

Freels found out at Averitt’s annual free health screening that he was at extremely high risk for a heart attack and possibly a stroke. “Those numbers were alarming,” he says, and he went almost immediately to see his family doctor. “He started to write me a prescription, but I asked if there was anything I could do medically. So he prescribed the South Beach Diet.” The South Beach Diet, originally designed partially by a cardiologist, is an alternative to other low-fat diets that revolves around the ideas of “good carbs” versus “bad carbs” and “good fats” versus “bad fats.”

By following the South Beach Diet, Freels was able to lose 30 pounds in 90 days. “I feel wonderful,” he says. “Got all kinds of energy, and I look forward to exercising each day. I weigh less than I did when I graduated high school — that’s always a good thing when you’re 40.”

Randy Freels (after)

Freels’ wife has also been following the diet, which he says helps tremendously. He says his back and joints no longer hurt as they did when he carried around the extra pounds. When he’s on the road, he packs his own meals and keeps snacks in his truck to help him stick to his weight-loss plan. “Don’t wait till you get starving to death and get in a truckstop with aisles and aisles of candy and quarter-pound hot dogs and all that stuff,” he advises. “Alcoholics don’t go to bars, and as a food addict, I just don’t go around where I could fall and make bad decisions.”

The motivation to prevent heart problems has provided great incentive for Freels to make the lifestyle changes necessary to lose weight and get healthy.

“I’ve got a new lease on life, and I’m going to stick with it,” he says.

FMCSA heart guidelines

The Federal Motor Carrier Safety Administration has multiple heart-related medical guidelines that determine the status of a driver’s CDL. The guidelines include the following:

A driver must not have a current clinical diagnosis of myocardial infarction (heart attack), angina pectoris (chest pain), coronary insufficiency (insufficient blood flow through one or more coronary arteries, or the arteries encircling the heart), thrombosis (blood clots) or any other type of cardiovascular disease that may be accompanied by loss of consciousness, breathlessness, collapse or congestive cardiac failure.

The driver can’t have a clinical diagnosis of high blood pressure likely to interfere with his or her ability to operate a commercial motor vehicle safely. Typically this means if the driver’s blood pressure is higher than 140/90 he or she likely will be granted a temporary medical certification of up to one year with periodic check-ups. With a blood pressure greater than 180/110, the driver cannot be qualified until his or her blood pressure is demonstrated to be below 140/90 with treatment well tolerated.

Additionally, FMCSA requires that the driver not have any established medical history or clinical diagnosis of vascular disease that interferes with his or her ability to operate a CMV safely. Vascular disease includes disorders that affect the integrity of blood vessels and arteries away from the heart; the disorders include peripheral artery disease, renal artery disease, Raynaud’s Disease, Buerger’s disease, peripheral venous disease, varicose veins and venous blood clots.

The key to these regulations is the qualifier that they interfere with an individual’s ability to safely operate a CMV. With some exceptions, such as the specific guidelines for blood pressure levels, many of these guidelines are left to the discretion of the doctor performing the CDL medical exam.

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